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VA watchdog stands by decision not to release report

WASHINGTON — The VA's interim inspector general said he stands by the initial decision not to release a report on high opiate prescription rates at a VA facility in Wisconsin, where a veteran overdosed.

VA watchdog stands by decision not to release report

Veterans Affairs Interim Inspector General Richard Griffin testifies on Capitol Hill in Washington, D.C., on Sept. 9, 2014. At a more recent hearing, Griffin said he stands by his office's decision not to release a report about “unusually high” opiate prescription rates at a VA facility in Wisconsin.(Photo: Lauren Victoria Burke, AP)

WASHINGTON — The interim inspector general at the Veterans Affairs Department said Thursday he does not regret his staff's initial decision not to release a report on "unusually high" opiate prescription rates at a VA facility in Tomah, Wis., where a veteran died from an overdose last August.

"At the time the decision was made, it was the right decision," said Richard Griffin, whose office completed the report in March 2014.

Griffin, who was on Capitol Hill to testify at a House Appropriations Committee hearing, recently began releasing reports on 140 investigations, including the one in Tomah. He said it was appropriate to initially withhold findings from those investigations and described at least some of them as a "dry well."

"Anybody that reads these as they come out ... will see that, if you were in our position, you'd make the same decision," he said during the hearing.

But six of the 17 previously unreleased reports his office released this week contain substantiated allegations, including two involving veterans who were harmed or died.

In Wichita, Kan., a veteran died after being switched to do-not-resuscitate status, despite his advance directive that he wanted to be resuscitated. VA staff had not scanned the advance directive into his chart.

In West Palm Beach, Fla., a veteran dependent on a ventilator was found unresponsive without a pulse after he was checked into a unit where staff weren't competent to care for such patients. He was resuscitated.

The others included findings of "nepotism and preferential treatment" and underuse of providers at a VA facility in Gainesville, Fla., that contributed to long patient wait times. In Grand Junction, Colo., a provider had been working as a physician assistant for years even though he had never been educated to be one. In Palo Alto, Calif., the VA facility lost a liver biopsy specimen.

Griffin's office began releasing the reports after USA TODAY reported earlier this month he had withheld from the public the findings of 140 health care investigations since 2006. On Tuesday, he announced a new policy that allows only his immediate staff to approve closing cases without a public report.

Sen. Tammy Baldwin, D-Wis., said that doesn't go far enough.

"This move by the VA inspector general is a disturbing acknowledgment that they have not had a standard policy governing the disclosure of reports — a glaring example of mismanagement that has allowed them to keep many investigative reports a secret," she said.

Baldwin has been heavily criticized for not acting on the Tomah report for months. She was the only member of Congress to receive a copy last August but her staff didn't realize the severity of the opiate problem it outlined, Baldwin has said. She disciplined her chief of staff, demoted her state director, fired her top aide in Milwaukee and reassigned a veteran outreach aide.

The Tomah report found there was no conclusive evidence of wrongdoing at the facility, but said providers there were among the top prescribers of opiates among more than 3,000 prescribers in a multi-state region, raising "potentially serious concerns."

A 35-year-old Marine veteran, Jason Simcakoski, died from an overdose as an inpatient at Tomah last August, five months after the inspector general's office completed its investigation into highly unusual opiate rates at the facility but did not release its report. Simcakoski died just days after doctors agreed to add another opiate to the 14 medications he was already prescribed.

The failure of the VA office of inspector general to make public and appropriately share the Tomah inspection report, and the fact that the VA leadership in Washington was unaware of problems at the facility in Tomah is simply unacceptable," Baldwin said.

She introduced legislation, co-sponsored by Sen. Ron Johnson, R-Wis., that would require Griffin to release reports on all future investigations in which inspectors make recommendations for improvement.

In addition, she joined fellow Democratic Sen. Jon Tester of Montana in sending a letter to President Obama on Wednesday asking him to nominate a permanent inspector general. Griffin is a deputy inspector general who has been acting as interim inspector general since the last head of the agency stepped down in December 2013.

"(W)e are particularly concerned by the lack of leadership and resulting ineffectiveness at the VA Office of Inspector General," Baldwin and Tester wrote.

Johnson wrote to the president asking the same thing in January. Rep. Jeff Miller, R-Fla., chairman of the House Veterans' Affairs Committee, also lambasted Griffin earlier this week and said it's "well past time" for Obama to nominate a replacement.

The White House hasn't said what the president plans to do.

"I don't know of any specific announcement regarding an inspector general," deputy press secretary Eric Schultz said last week. "I would say it's my understanding that the administration profoundly respects and admires the work of inspector generals across the administration and throughout various agencies, whether they are Senate-confirmed or not."

No member of Congress from Wisconsin attended Thursday's hearing because none sits on the Appropriations Committee. They will get their chance at a hearing in Wisconsin on March 30 to question Dr. John Daigh, assistant inspector general for health care inspections, who personally signed off on closing the Tomah case without a public report.

Griffin said during a recess in Thursday's hearing he wants to retain authority to continue closing investigations without public reports. He said he is releasing the previous reports to disprove any notion that they are "secret reports, that we're hiding stuff."

"That's why we're releasing them now," he said. "We hope to be able to revert back to common-sense efficiency once people realize that we're not playing games."